External fixation of fractures has been practiced extensively, and there exists a number of external fixation devices designed to fix fractures of the ankle. Generally, these devices attach to the tibia with bone pins, span the fracture, and attach to bones of the foot, the talus and calcaneus, to secure the fracture while it heals. Some of the devices are designed to provide a pivot point in the external fixator adjacent to the natural hinge point of the patient's ankle. It is suggested by some that allowing the external fixator and ankle to pivot at some times during the healing process is advantageous. This view is not held by all, and some of the external fixators are not designed to pivot in this manner, or are designed to be lockable to selectively inhibit any pivoting prior to healing. Some external fixators are also adjustable longitudinally.
However, none of the existing external fixation devices are capable of adjustment and consequent fine adjustment of a fracture reduction lateral or transverse to the longitudinal axis of a fixator once the fixator has been placed on the bone pins and tightened. Therefore, if any transverse fracture reduction adjustment is needed, the fixator must be loosened, the fracture realigned, and the fixator tightened again. Prior devices also fail to give significant flexibility in pin placement and orientation in the foot of a patient. It is important that external fixation devices for the ankle be easier to use, less cumbersome, and more versatile than existing devices, particularly when used in a trauma setting.
Accordingly, there is a need for apparatuses and methods optimized to enable convenient placement and locking of an external fixator and apparatuses and methods that provide for fine adjustment of fracture reduction without requiring loosening of the external fixator. It would be additionally advantageous to enable manipulation of the external fixator in greater degrees of freedom in order to more effectively and efficiently place fixation elements such as bone pins. Furthermore, it would be advantageous in certain embodiments to provide for rotatable removal and attachment means for multiple fixator configurations. All of these are particularly important in the context of ankle fixators, even though it is possible for concepts, features, and aspects of the invention, and embodiments of it, to be used in the context of other points in the human body.